Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 05978 | Date 30/05/2022 |
| Token No | SM/22-23/5539 15/10/2022 | Serial | 001 |
| Patient Name | Mrs. MRIDULA GHATAK | Contact No | 8582884461 |
| Address | 74/B J N LAHIRI ROAD | Age | 57 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||